Battling Obesity

At the Gates Chili High School near Rochester, N.Y., the cafeteria and kitchen are getting an overdue overhaul. Debbi Beauvais, the district's food-service supervisor, was reviewing the design plans for the renovation when the architect pointed out where he planned to put the deep fryers.

Those last two words hung uncomfortably in the air for a few seconds. “Uh, excuse me,” Beauvais sighed, “We'll be taking those out.”

Deep fryers and the fat-soaked foods that come dripping out of them are no longer welcome in the kitchens and dining halls of a growing number of the nation's schools and universities. Likewise, heavily marketed sugary soft drinks and fat-laden candy treats are vanishing from school vending machines.

From California to New York, education institutions are enlisting in a war against obesity. The battle plan calls for schools to teach students how to choose more nutritional foods, and for food-service workers to practice in the lunchroom what instructors are preaching in the classroom. That means menus that offer more fruits, vegetables and whole grains, entrees that are baked instead of fried, and juice and fat-free milk instead of the empty calories of soft drinks.

It also means making cafeterias and dining halls appealing spaces where students can get the food they want quickly and still have time to hobnob with their friends.

“When you go someplace to eat, if you like the ambience and you get good customer service, you're going to come back,” says Linda Hayes, director of nutrition services for the Moreno Valley (Calif.) Unified School District.

A big issue

Put simply, the problem is this: America has a weight problem. We eat too much, we eat the wrong things, and we don't exercise enough to burn off those excess calories. Americans are fatter now than they were 25 years ago. The 1999-2002 National Health and Nutrition Examination Survey found that 65 percent of U.S. adults were overweight or obese, compared with 47 percent in the 1976-1980 survey. The percentage of obese adults has risen from 15 percent in 1976-1980 to 31 percent in 1999-2002.

Obesity is a societal problem too vast for schools and universities to defeat on their own — most education institutions aren't in a position to influence the long-established dietary habits of overweight adults. But the alarming health statistics are not confined to adults. The same health survey found that 16 percent of young people aged 6 to 19 were considered overweight. In the 1976-1980 survey, only 7 percent of those aged 6 to 11, and 5 percent of those 12 to 19 were considered overweight.

What young people eat during the day is an issue that the nation's schools are well-positioned to tackle. From snacks and lunches in preschools to multi-course meals in college campus dining halls, education institutions typically have a dozen or more years during which they can provide healthful food to students and instill in each of them good nutritional habits.

The federal government gave a strong vote of support for the war on children's obesity in 2004 when Congress passed the Child Nutrition and WIC Reauthorization Act. It requires that school districts create a wellness policy that addresses goals for nutrition education, goals for physical activity, nutrition guidelines for foods available at school, and assurances that school meal guidelines are not less restrictive than federal guidelines.

Improving the product

Schools and universities are being more vigilant about nutrition as they choose what to serve their students. A few years ago in the Gates Chili district, students were able to buy a six-pack of mini chocolate donuts in the lunchroom as a snack.

Beauvais has removed many unhealthful options like those. Students are more likely to see fresh fruit and vegetables, and whole-grain products. The cafeterias offer no whole milk, only skim or 1 percent; and the white rice has been replaced with brown rice. “The way we season it, the kids can't tell the difference,” says Beauvais.

In some cases, new equipment can help schools offer students better nutrition. At Gates Chili High School, the kitchen doesn't have the right ovens to make its own pizza, so it has a local pizzeria bring in its product. The kitchen renovations will include new ovens that will enable the school to prepare and cook its own pizza.

“We can control the ingredients and the toppings, and we can make sure it's healthy,” Beauvais says.

But even without new equipment or a redesigned kitchen, schools can improve the nutritional quality of their meals.

“You can make a tossed salad in any kitchen,” says Beauvais. “It's really a matter of creative menus.”

Conscientious campuses

Colleges and universities also are making efforts to make behind-the-scenes changes that result in more healthful dining. Earlier this year, the dining halls at Virginia Tech in Blacksburg, Va., decided to eliminate the use of oils with trans fats, which can negatively affect cholesterol levels.

For some students, choosing what they eat may involve more than personal tastes, nutritional issues or cost. For philosophical reasons, many may choose a vegetarian or vegan diet. Some who are concerned with preserving the environment and how food products are grown, harvested and brought to market may prefer to buy and consume organic items.

“Students have a far more heightened level of conscientiousness about health and social issues,” says Jodi Smith, marketing director for the National Association of College and University Food Services. “They are more aware of what they're putting into their bodies. They are interested in organics and sustainable practices.

Indiana University in Bloomington was chosen by the People for the Ethical Treatment of Animals (PETA) as the most vegetarian-friendly college with offerings such as sesame noodle and peapod casserole.

“We have a lot of salad bars, paninis, wraps and other health-conscious menu items,” says Sandra Fowler, director of residential dining services at Indiana University. “We meet regularly with students to discuss changes and additions.”

Cal Dining, the food-service operation at the University of California Berkeley, has responded to its students' desires by having its Crossroads dining commons become the first college food operation to be certified as “organic.”

“We thought the salad bar was a logical place to start,” says Chuck Davies, associate director of residential dining for Cal Dining. “There is a lot of produce in California, and the price is good.”

All fresh and canned agricultural products are provided by certified organic vendors. Organic products are labeled with stickers to ensure they are not inadvertently mixed with non-organic times. Cal Dining has expanded the availability of its organic salad bars to other dining venues.

“It was a response to student demand,” says Davies. “They are looking to be more socially responsible. We try to do as much local purchasing as possible, we buy fair-trade coffee, we're eliminating trans fats. The trend is not going away.”

At the same time, the student body at a college campus is a diverse group of people old enough to make their own decisions about what they want to eat and what is good for them.

“We're not the food police,” says Davies. “There are still a whole lot of students who want pizza and hamburgers.”

Fast and appealing

Clearly, offering more healthful food is the obvious first step that schools need to take as they strive to improve the diets of their students. But the next step in the process may be more daunting: getting students to eat what is being offered. To make this happen, administrators have to take into account a student's overall dining experience. That means a careful assessment of the kitchen and dining facilities and operations.

In an elementary or secondary school, is the lunch period at the right time of the day? Are there signs posted that help students navigate through the congestion of hungry classmates? Can students move through the lunch line quickly enough to have time to eat without feeling rushed? Are there alternative ways of buying a meal if lunch lines are too long? Can students get a meal without having to disclose whether they are receiving it free or at a reduced price? Are there enough seats for all the students assigned to the lunch period? Is the space designed and decorated to appeal to students? Is it a comfortable place for students to hang out and socialize?

On a college campus, are there enough dining locations to satisfy the needs of students constantly on the go? Are the dining venues and the food offerings varied enough to appeal to students and staff of different ethnic backgrounds, dietary restrictions and eating philosophies? Are the facilities inviting enough to keep students spending their time and money on campus instead of seeking out off-campus retail restaurants that are more to their liking?

And, all the while that schools and universities are trying to find the right answers to those questions, they must ensure that those choices stay within the food-service budget.

“It's a fine tightrope we walk,” says Fowler.

Many schools try to offer the familiarity and convenience of restaurants and food courts students know and love, and provide comparable service, but with food that is nutritionally superior than typical fast food.

That might mean a high school that sells lunch entrees from a kiosk or a traveling cart in a school courtyard where kids like to hang out, or a college that sets up a deli counter in its library. It might mean colleges with no defined meal times, where multiple eating options are available virtually around the clock.

“It's a grab-and-go world,” says Fowler. “That's what we have adjusted to. I have had parents say, ‘Why don't you just offer three meals a day and make them do that?’ And I say, ‘Well, they didn't do that at home did they?’”

The right space

In “Healthy Children Ready to Learn: Facilities Best Practices,” the state of California offers schools guidance for creating food-service spaces that encourage students to eat more healthfully:

When planning a new or renovated kitchen or cafeteria, include food-service workers in the process. “The knowledge shared by these experts who utilize the space in their day-to-day operations will spark innovations and prevent inefficient design,” the report says.

In the Moreno Valley (Calif.) district, many of the food-service areas were redecorated to be more appealing to students. Hayes says she worked with students in choosing the themes and colors, which typically were related to a school's mascot and traditions.

The seating areas available for students should be comfortable and convenient, the best-practices guide states. Schools also should consider giving students the option of eating elsewhere on campus, in less structured settings. When the weather is warm, many students want to eat outdoors, and if schools can accommodate that, the students are more likely to eat the nutritious food the school offers.

Offer healthful and convenient options at point-of-sale. Shorter lunch periods that have more students trying to eat can bog down food lines and discourage students too impatient to wait.

“Many students will skip lunch rather than wait in long lines,” the report says. “To help increase student participation, many schools have shifted food delivery methods in favor of convenience and speed of delivery.”

Schools can offer healthful “grab-and-go” choices, and they also can bring in extra workers to make the lines move faster. In Moreno Valley, Hayes says she has as many as 10 cashiers at her high schools so that students can't use long lines as an excuse for not buying lunch.

Schools should provide more dining space to account for enrollment growth. As campuses have become more crowded and schools have added more lunch periods, many students are assigned eating times much earlier or later than the traditional noontime schedule.

“This solution is not ideal for maintaining consistent blood-sugar levels, which is important for students' academic focus and concentration,” the report says. “A better alternative is to plan the core facilities with long-term growth in mind.”

Another option for freeing up space, the report says, is building remote satellite facilities where food is prepared offsite and delivered to a school.

Mom and Dad are watching

At many schools, parents can use an online system to establish a lunch account for a student. Students use a card or some other identification method, and the system automatically deducts the cost of a meal.

The accounts enable a student to gain access to money for meals without having to carry cash that might tempt a schoolyard bully. It also enables students who receive free or reduced-price meals to receive their food without having to disclose their financial status to other students or cafeteria workers.

The online systems let parents keep track of how much their kids are spending on meals, but they typically don't tell parents what their kids are buying. That's no longer the case at schools taking part in a pilot project in the Gates Chili (N.Y.) district. Parents can connect online to their children's lunch account and see if they're buying the school lunch, or spending it on less healthful a la carte snacks and desserts.

“I've had lots of phone calls from parents, so I know a lot of them are keeping track of it,” says Debbi Beauvais, food-service supervisor in the Gates Chili district. “Some of them end up putting money only in the meal account and not in the general (a la carte) account.”

The Indian River County (Fla.) district is part of a similar pilot at one of its high schools. It not only records what food items a student buys in the lunch line, but also what is purchased from school vending machines. The machines accept ID cards or biometric information from students, and the system charges purchases to a student's account, says Joe Clark, an educational technology specialist in the district.

“These machines don't reveal your (free lunch) eligibility as you use them,” says Clark. “We can put vending machines with healthy snacks or healthy entrees in a courtyard or other places outside the dining area so students have more options.”

A hard line on soft drinks

Even if food-service workers at a school are doing everything they can to improve the nutritional value of the meals they produce in their kitchens, their efforts may fall short if elsewhere on campus a student can plunk a few coins into a vending machine and get a cold can or bottle of soda pop.

The push to remove sugary soft drinks from schools can result in a turf battle. One faction of a school's administration shouts “Good Health!” and another faction counters with “More Revenue!” Many schools and universities have signed lucrative deals that give a beverage company exclusive selling rights on a campus. Nutritional advocates have argued that allowing or encouraging soda consumption through these contracts is not good for students' health, but schools with tight budgets may be reluctant to jettison an ongoing source of funds, especially if the money supports an activity that might not be viable without soft drink profits.

But as the momentum has grown for good nutrition in schools, soft drink companies have seen the writing on the cafeteria walls. In 2006, the nation's top three soft-drink companies — Coca-Cola, PepsiCo and Cadbury Schweppes — agreed that only lower-calorie and nutritious drinks will be sold to schools. Working with the Alliance for a Healthier Generation, the soft-drink industry has developed guidelines that cap the number of calories in beverages sold at schools at 100 per container, except for certain milks and juices whose nutritional value warrants a higher number of calories.

Other elements of the guidelines:

Elementary schools will sell only water, and eight-ounce servings of fat-free and low-fat regular and flavored milks, and certain juices with no added sweeteners. Middle schools have similar guidelines, except that the serving size is raised to 10 ounces.

In high schools, at least half of the beverages for sale will be water, no-calorie or low-calorie drinks. Light juices and sports drinks will be sold in 12-ounce containers with no more than 100 calories per container.

The beverage companies will work to put the standards in place at 75 percent of the nation's schools by summer 2008, and at all schools by summer 2009.